A 58-year-old male farmer from rural Maharashtra presents to the primary health centre with a 6-month history of exertional chest discomfort and dyspnea. He has never smoked but chews tobacco daily for the past 20 years. His father died of myocardial infarction at age 62. On examination, BP is 148/94 mmHg, heart rate 88/min regular. Fasting blood glucose is 126 mg/dL, total cholesterol 245 mg/dL, LDL 165 mg/dL, HDL 32 mg/dL, triglycerides 180 mg/dL. ECG shows nonspecific ST-T changes. Based on the epidemiology of cardiovascular disease in India, which single modifiable risk factor accounts for the largest attributable population risk in this patient's presentation?